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Home My WebLink About2002-P04869 - re-roof • 3 CITY OF ORONO PERMIT 2750 Kelley Parkway- PO Box 66 Permit Number: Poas69 Crystal Bay, Minnesota 55323 Pe�mit Type: MinorAlterations (952) 249-4600 Date Issued: 2iai2oo2 SITE ADDRESS: 3605 North Shore Dr WAYZATA,MN 55391 P I D: 08-117-23-3 4-0011 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 153.25 Valuation• $ 7,850.00 State Surcharge Fee: $ 3.95 TOTAL FEE: $ 157.20 APPLICANT: �'•F. Smith Construction OWNER: LAURENCE A JONES&WIFE 5975 Lynwood Blvd 3605 NORT'H SHORE DR Mound,MN 55364 WAYZATA MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEI�NTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. E � � � �<h�,-- ��vti- �' � APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Coaies: 1-File(SiQnitures Required). 1-Annlicant, 1-Monthlv Reports. 1-Assessin¢, 1-Finance Page 1 � � �;�:� v �"� Total Fee: $ ��,a� Date Received: �� Entered By: �_ Permit#: CITY OF ORONO - BUILDING PERNIIT APPLICATIUleT All information must be submitted in full before plan review will be started. (please print all information) --------------------------------------------------------------------------------------------------------------------- THE APPLICAN'I' IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �-� �� ti o,�-/� S/-� .�� z�: s s�� NANIE OF OWNER: �i(L�(L� C�, C56�/t,�' PHONE: (home) (work) MAILING ADDRESS: S�`� CITY: ZIP: CONTRACTOR: � . C� � . �IvS� , PHONE: L'j Sc� —�'I�a ' �� t I CONTACT PERSON:�� fl MOBILE/PAGER: �h'? —3 ; I � MAILING ADDRESS: 59 `7 S- �-Y!�v�;�p �t';�,�p CITY: 1'�Q�N� ZIP: SS3�� STATE LICENSE: # S�� ARCHIT'ECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF `VORK: New Addition Accessory Structure Move Remodel/Alteration�_ Land Alteration PROPOSED WORK(describe in detain: � �-�� cSE:� �— \C-t; S�-, 1�6(,�, STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. � c�c� ESTli1�IAT'ED CONSTRUCTION VALUATION (excluding land): $ � ,� � �' I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City and with the State Building Code; that I understand this is not a pernut and work is not to start without a permit; and that the work will be in accor c with e approved plan. APPLICA��1T'S SIGNA DATE: �—" � ` � � NOTE! Parade of Fiomes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. � , Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or co be stored shall be as set forth in this section. Subd.2. Informadon reqtrired to be given individual. �.n individual asked to supply private or confidendal data conceming himself shall be inforated of: (a) the purpose and in[ended use of the requesttd data within the collecting'state agency, polidcal subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply[he requested data;(c)any lmown coasequence arising fmm his supplying or refusing to supply privace or confidential data;and(d)the idenary of ocher persons or enaaes authorized by state or federal law to receive the data. This requiremenc shall not apply when an individual is asked to suppty invesrigadve dara,pursuant[o secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�•enue mav place the norice reauired under this subdivision in the individual income tax or propem taz refund instructions inscezd of on chose forms. Subd. 3. Access to data by individuai. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whe[her i[is class�ed as public, private or confidenual. Upon his further request, an individual who is che subjec� of stored private or public data on individuals shall be shown che data wichout any charge to him and,if he desires, shall be informed of the contenc and meaning of[hat data. Aher an individual has been shown the priva[e data and informed of its meaning,the dara need not be disclosed to hun for siz months[hereafrer unless a dispuce or acdon pursuanc to this secaon is oending or addiaoaal data on the individual 6as been collected or created. The responsible auchoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the actual costs of makin¢,cerrifying,and compiling the copies. The responsible authoriry shall comply immediacely, if possib(e, wieh any request made pursuant to this subdivision,or within five days of the date of the request,ezcluding Sacurdays,Sundays and legal holidays,if immediate compliance is noc possibie. If he cannot comply with the requesc within[hat time,he shall so inform the individual,and may have an addidonal five days within which to comply with che request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate data conceming himself. To exercise this right,an individual shall noafy in wriring ehe responsible authoriry describing�he nature of the disagreement. The responsible authoriry shall within 30 days ei[her: (a)correcc che data found to be inaccurate or incomplete and attempe to nodfy past recipients of inaccurate or incomplete data, including recipients named by che individual; or(b)nodfy the individual that he believes che data to be correct. Data in dispu[e shall be disclosed only if the individuat's statement of disagreement is included with the disclosed data. The decerminarion of the responsible authoriry may be appealed pursuan[to the provisions of[he adaunistradve procedure act reladng to contesred cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Rig.hts of subjects of data", we would like to inform you that your reauest for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that che Ciry deny the pemut or license. 3. The information may be shared with o[her local, state or federal a;encies to the extent necessary to process the pernut or license. 4. If your requested pernvt or license requires Council action to approve, some information may become public. j. You have certain rights under M.S. 13.04 (available upon request) to review priva[e data on yourself. 6. Your full name is required to process this application or permit. �'� �� C � �` �� First Middle 1� Last ��i -7 S L�Iv �.'a� �1 F��L�� ' Address ��`��,� �� `l�!\�c� S�s'� � i�� - y 7�- �6 S 3 �l Cih, Stare Zip Phone I u derst d my hts stated abo � �� Signature � DATE TIME CITY OF ORONO CALLED IN INSPECTION NOT E SCHEDULED - PERMIT NO.�� COMPLETED 'U ' �U ADDRESS ��5 !�D/�TI�cS�,^L.... ��° OWNER CONTR. �'�• �/"u� �Gc Cd�SI— TELEPHONENO. �S o�-y7� -lr�,�3 g - ,,. 4. l2_�(�.7-3/l Z. � DESCRIPTION � �OC} f - �-e'C< /' O f-� � 01 FOOTING 11 MECHANICAL RI 18 EXCA�J/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � .�'�j �_ C � c�� o �� .- � 0 � W � Q � z W � W � � �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W -�0 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVEFING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�� OwnerlConUaatQr on site: Inspector. t✓��C�` �" Y White Copyllnspector's File Canary Copy/Site Notice